UMEM Educational Pearls

Category: Geriatrics

Title: polypharmacy in the elderly

Keywords: geriatrics, polypharmacy, elderly (PubMed Search)

Posted: 4/10/2011 by Amal Mattu, MD
Click here to contact Amal Mattu, MD

We already know that polypharmacy is a big issue in the elderly, but here are a few key points to keep in mind:
1. Adverse drug effects are responsible for 11% of ED visits in the elderly.
2. Almost 50% of all adverse drug effects in the elderly are accounted for by only 3 drug classes:
     a. oral anticoagulant or antiplatelet agents
     b. antidiabetic agents
     c. agents with narrow therapeutic index (e.g. digoxin and phenytoin)
3. 1/3 of all adverse-effect-induced ED visits are accounted for by warfarin, insulin, and digoxin.
4. Up to 20% of new prescriptions given to elderly ED patients represents a potential drug interaction.

The bottom line here is very simple--scrutinize that medication list and any new prescriptions in the elderly patient!


Samaras N, Chevalley T, Samaras D, et al. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-269.